Insurance Specialist: Job Description and Education Requirements
Insurance specialists are experts in interpreting insurance policies and determining coverage. With specialized training in billing and coding, they may work in medical and government offices, hospitals and laboratories.
Insurance Specialist Job Description
Insurance specialists are trained to decipher complicated insurance laws and policies. In a government capacity, insurance specialists may be responsible for ensuring that government programs, such as Medicare and Medicaid, comply with federal law, regulations and contracts. Specialists may advise on issues related to eligibility and coverage, as well as monitor the compliance of government contractors.
Many insurance specialists are also employed in the health care industry. As such, they may deal with health insurance billing and payments including interpreting billing codes and processing claims. Specialists may also be expected to keep track of patient records and perform other functions integral to the running of a medical office.
Insurance Specialist Education Requirements
While many of the skills necessary to the profession may be learned on the job, prospective insurance specialists may want to consider specialized training in the field. In the health care arena, schools offer certificate and associate degree programs for medical or health insurance specialists. These programs offer courses in medical coding, medical terminology and health care law. Graduates may be qualified to earn Health Insurance Portability and Accountability Act (HIPAA) Certification, which shows a greater understanding of the federal statute, which governs privacy of patient medical information.
For those seeking additional credentials, there are certification programs available to highlight specific skills. For health insurance specialists, the National Center for Competency Testing (NCCT) and the American Academy of Professional Coders (AAPC) offer various certifications. The NCCT offers the Insurance and Coding Specialist certification (www.ncctinc.com). The certification exam for an NCCT credential tests knowledge of medical coding, procedures and terminology. The AAPC offers certifications that reveal expertise in medical coding such as the Certified Professional Coder and the Certified Interventional Radiology Cardiovascular Coder (www.aapc.com).
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